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1278 Glenn Haven Dr..,, Chico
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BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #:(530) 538-7541 FAX#: (530) 538-2140
WEBSITE: www.buttecounty.net\dds
PROJECT INFORMATION
Site Address: 1278 GLENN HAVEN DR
Owner:
Permit NO: B07-2249
APN: 042-350-019
SCHULLER PAUL F & KA,
Issued Date: 10/31/2007 By KEJ
Permit type: MISCELLANEOUS
1278 GLENN HAVEN DR
Subtype: Gas Reconnect
CHICO, CA 95926
Expiration Date: 10/30/2008
Description: GAS LINE FOR FIREPLACE
(530) 343-6180 -
Occupancy: Zoning: R1
Contractor
Applicant:
Square Footage:
SCHULLER PAUL F & KA,
SCHULLER PAUL F & KA,
Building Garage Remdl/Addn
1278 GLENN HAVEN DR
1278 GLENN HAVEN DR
CHICO, CA 95926
CHICO, CA 95926
Other Porch/Patio Total
(530)343-6180
(530)343-6180
FEE INFORMATION
DBP Gas System (enter outlets) $58.00
Total Charged: $58.00 Fees Paid: $58.00
Balance Due: $0.00 Receipt No: B5164
LICENSED CONTRACTOR'S DECLARATION
OWNER / BUILDER DECLARATION
Contractor (Name) State Contractors License No. / Class / Expires
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License
SCHULLER PAUL F & KA, OL:CRW 00377149 / /
Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that
requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance,
,
also requires the applicant for such permit to file a signed statement that he or she is licensed
pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000)
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license
is in full force and effect.
of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
X 10/31/2007
the applicant to a civil penalty of not more than five hundred dollars [$500];
Pleas check one of the following:
Contractors Signature Date
I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE
COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR
WORKERS' COMPENSATION DECLARATION
OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractors License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:
the work himself or herself or through his or her own employees, provided that such improvements
❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR
are not intended or offered for sale. If, however, the building or improvement is sold within one
WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the
year of completion, the owner -builder will have the burden of proof that he or she did not build or
performance of the work for which this permit is issued.
improve for the purpose of sale.).
HAVETHE
❑CONTRACTORS
TO CONSTRUCT PROJECT (Sec. 7044, Business and Provessions Code:
ection 3700 of the Labor Code, for the performance of the work for which this permit is issued.
The Contractor's License Law dows not apply to an owner of the property who builds or improves
My Workers' Compensation insurance carrier and policy number are;
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractors License Law.).
Cartier: Policy Number. Exp. Date:
(This section nee not a competed if the permit is or one hundred ($100) or ess.
❑ I AM EXEMPT under Section B. & P.C. for this reason:
ERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS
611,CSUED,
X --10/31/2007
I shall not employ any person in any manner so as to become subject to the Workers'
Compensation laws of California, and agree that if I should become subject to the workers'
cot* provisions of Section 3700 of the Labor Code, I shall forthwith comply with those
P)ds'
Owners Signature Date
X
���-0/31/2007
I hereby certify that I have read this application and state that the above information is correct. I agree
to comply with all City and County ordinances, rules, regulations, and Slate laws relating to building
Sig lute Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
construction, and with any and all conditions of permit. I agree to defend, indemnity, and hold harmless
Butte County, its officers, agents and employees from any and all claims and liability for personal
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
injury, including death, and property damage caused arising out of, or in any way connected with
HUNDRED THOUSAND DOLLARS $100,000 , IN ADDITION TO THE COST OF COMPENSATION,
( )
the issuance of this permit. I hereby acknowledge thatt is issuance of this permit does not authorize the
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte
ATTORNEY'S FEES.
County enter the above me boned p perry for i sp coon purposes. I hereby certify that I am the
prop owner or am autho d to n the owners behalf.
CONSTRUCTION LENDINGAGENCY
10/31/2007
N me VIF Pe mittee7[S!GN]r - Pfint Date
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for
the performance of the work for which this permit is issued. (3097 civ. code)
❑ Owner 1:1 Contractor OR; Agent for Owner Agent for Contractor
FILE COPY
Lenders Address City State Zip
, Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 95965
(530) 538-7601 Telephone
(530) 538-2140 Fax
www.buttecounty.net/dds
OWNER -BUILDER INFORMATION
An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified.
For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed
by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from
possible liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by
law to put their license number on all permits for which they apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and
protection:
° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire
project and such persons are not licensed as contractors or subcontractors, then you may be an employer.
° If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal
° income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions.
There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance.
° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business
Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial
Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees,
without a license contractor or subcontractor, only under limited conditions.
A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is
providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321
-CLSB (2752) or by accessing thier website at www.CSLB.ca.gov.
PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE
AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED.
OWNER BUILDER VERIFICATION
PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING
PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED.
1. I PERSONALLY PL TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY
IMPROVEMENT.( S RNO)
2. (HAV VE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK.
3. I HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION:
NAME
ADDRESS CITY.
PHONE CONTRACTORS LICENSE NO
4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE
THE MAJOR WORK:
ADDRESS
PHONE
CITY
CONTRACTORS LICENSE NO
I WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED:
NAME ADDRESS PHONE TYPE OF WORK
Description: GAS LINE FOR FIREPLACE
Reference Number: B07-2249
Applicant Name: SCHULLER PAUL F & KA,
Owner's Name: SCHULLE AUL F & AP h
Signature of Property Owner: Date:
:042-350-0 9
3 �;2clo 7
BUTTE COUNTY
o�vTTF0 DEPARTMENT OF DEVELOPMENT SERVICES
o o BUILDING PERMIT APPLICATION
o o OFFICE #: (530) 538-7541 FAX #: (530) 538-2140
o-- =o
o o A FEE WILL BE REOUIRED AT TIIYIE OFAPPLICATION
CO,� �,�•� Website: www.buttecounty.net/dds
**PLEASE PRINT CLEARLY**
OWNER INFORMATION
Las am '
Fi t Name �-
Mailing Address
l�
City / L
State /�
C
Zip
Phone '3 j3
Fax
E-mail ,v e -
U -
APPLICANT INFORMATION
CONTRACTOR
Name
City
Address
Zip .
City
Fax
State
Zip
Phone
Fax
E-mail
Lic. #
Class
APPLICANT INFORMATION
ARCHITECT/ENGINEER
Name
City
Address
Zip .
City
Fax
State
Zip
Phone
Fax
E-mail
State License Number
APPLICANT INFORMATION
Name
Address
City
State
Zip .
Phone
Fax
E-mail
APPLICANTSIPNATURE
� wa, V., - Id rwom A F N
PROJECT LOCATION
AP#
D t2 -
Property A
City
PERMIT
NO. �9,,
C11
BIN It
WORKER'S COMPENSATION
Policy Number
Carrier
If hiring anyone other than license contractors, a certificate of worker's
compensation must tie shown at the time of permit issuance.
LENDING AGENCY
Name
Address
DESCRIPTION OR SCOPE OF WORK:
e
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42 -
Sq FT- Living Garage Open Cov
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use): ,
For office use only:
ZoningT
I Flood Zone
SRA I Yes I No
Occ.
Type Const.